We describe two unusual surgical cases who presented with extraforaminal lumbar disc herniation that occurred at two adjacent vertebral levels simultaneously and unilaterally. Magnetic resonance imaging and selective nerve root infiltration followed by radiculography helped to outline the herniated disc material. Lateral fenestration and microsurgical foraminal widening of the affected vertebral levels allowed a complete and safe relief of the compressed nerves.
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http://dx.doi.org/10.1038/sj.sc.3100525 | DOI Listing |
World Neurosurg
January 2025
Department of Clinical Medicine - Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, DK-8200, Aarhus N.
Aim: The aim of this study was to investigate patient-reported outcomes (PROs) following lumbar discectomy on patients with lateral lumbar disc herniation (LDH) compared to patients with paramedian LDH.
Background: Surgery for disc herniation is one of the most common procedures of the lumbar spine. LDHs can be divided into median, paramedian, foraminal and extraforaminal types based on the anatomical site of the lesion.
BMC Musculoskelet Disord
January 2025
Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, P. R. China.
Objective: The aim of this study was to describe the technique of percutaneous paravertebral endoscopic decompression for the treatment of far-out syndrome and to analyze the early clinical results of this technique.
Methods: From April 2021 to June 2023, a retrospective study was conducted on patients with far-out syndrome who underwent percutaneous paravertebral endoscopic decompression at Hospital of Chengdu University of Traditional Chinese Medicine. The Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria were utilized for the assessment of leg pain, quality of life, and clinical efficacy, respectively.
We present a novel technique to approach far lateral lumbar pathologies using a bitubular, biportal endoscopic system and a paramedian approach. Background: Conventional approaches for lumbar far lateral discectomy range from open approaches to newer minimally invasive approaches such as tubular discectomy and single portal endoscopic discectomy. We present a case of a patient suffering with a left L3-4 and left L4-5 extraforaminal disc herniation who was treated successfully with a left sided bitubular, biportal endoscopic 2 level far lateral discectomy.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Neurosurgery, Spine Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management.
View Article and Find Full Text PDFActa Neurochir (Wien)
December 2024
Neck-shoulder and Lumbocrural Pain Devision 1, Sichuan Province Orthopedic Hospital, Chengdu, 610041, China.
Background: For L5/S1 extraforaminal disc herniation, how to efficiently expose the herniated nucleus pulposus and reduce facet joint damage remain to be explored.
Methods: Lumbar discectomy was performed using a full-endoscopic transsacral approach, in which sacral ala and extraforaminal ligament were partially resected to expose the L5/S1 intervertebral disc. Methylene blue was used for disc staining, and the herniated nucleus pulposus was excised through the annular tear.
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